Letter of Medical Necessity

Please use these links to access the Otezla Letter of Medical Necessity.

To receive by fax, or if you have any questions, call Otezla SupportPlus™ at 1-844-4OTEZLA (1-844-468-3952)

Download the Otezla Letter of Medical Necessity here

This document is provided for use by healthcare professionals
The Otezla Letter of Medical Necessity is provided to assist with appealing a coverage denial for an Otezla prescription
What happens if the Otezla Letter of Medical Necessity has been denied? If a coverage appeal is still denied, refer the patient to Otezla SupportPlus™ to determine eligibility for the Patient Assistance Program
Call Otezla SupportPlus™ with questions toll free 8 AM – 8 PM ET, Monday – Friday